TDNet Discover

Introduction: Cesarean delivery is one of the most commonly performed surgeries in the United States, with over 1.2 million procedures annually. While single-shot spinal anesthesia remains the standard for cesarean delivery due to its rapid onset and dense blockade, the fixed duration of local anesthetics such as bupivacaine may not always be sufficient for longer or more complex surgical cases. If the spinal anesthetic wears off before surgery is finished, providers may need to give IV medications or switch to general anesthesia, both of which carry added risks for the patient. This project began with a simple question: how can we extend the duration of neuraxial anesthesia without adding unnecessary complexity or risk? Dexamethasone, a corticosteroid routinely used in the operating room, has emerged in the literature as a promising adjunct to prolong sensory and motor blockade when added to local anesthetics. Although the precise mechanism of its intrathecal action remains under investigation, studies suggest that it works by reducing inflammation, interrupting nociceptive signaling, and stabilizing overactive nerve activity. Given the growing body of evidence supporting its use, this project was developed to bridge the gap between research and practice. By educating providers on the benefits and proper use of intrathecal dexamethasone, we aim to improve adoption rates and promote more consistent pain control in cesarean deliveries.